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HomeMy WebLinkAbout3251DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 73.- 1- 41.122 BOX 26 03251 4. „ yti I me No No No is is I -1 No ol : _ i ti f - ., . 61 46 n ` 03251 PCHD AM COUNTY DEPARTMENT OF HEALTH FI.IVISION OF ENVI_ RONl_VIIE,NT -REAL'�'H ..�.�.wi. .r -.. ra. i`�T[:'Y''as• �/.nw. ..-.y, .'T -^i/y �-ro'wl.�. .e yATa T/i A -iA .;1 Y%TE•h ..r. . ..."s .rj`'"- '1.af -Y._°Z CATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE TREATMENT SYSTEM PERMIT # P V- S- 97 Located at C H E I3 AY L r4 J E" SWO SE- - HIi_L Owner /Applicant Name P'K 0PE R 7'/ E S i N c• Formerly Town or Village P u VAL _E Tax Map `7 3 Block t Lot RESu 73 P 1 �J I Sio�J OF L 07- t Su'eL_ r' b Z B� Subdivision Name S uN s ,5-r- H 1 LL FILO PE`fZT /ES ;-) C. CM''f-=W Subd. Lot # 2-9 Mailing Address 15a 5 UN S ET HILL p, a A n 'PO-7r/007-4 U+4 L L E- Y Zip /05-79 Date Construction Permit Issued by PCHD SU ^J 19 CNES'TE1� ALA Ct Separate Sewerage System built by Fu -r tJ A M CoArMig e-r I rJ G Address _ L q K6 'p E E_I<S K L L , N.. y Consisting of 12 5 0 Cc.N 2 Gallon Septic Tank and 4 0 0 L= F, o f 24 " G 6 AV E L — FKQ- N C Other Requirements: Z' o f P? :^3 K p u J, C U R -FA I N D t-J A I m t Pu (1-7 ? S y S 7- E 7,4 Water Supply: Public Supply From Address. 1!3* 2 I5AKGE-l-� ST, or: x Private Supply Drilled by No wvi- q/i f *J'UE K S a'N Address Fu rNA N Up LCE)4 h L/. , Buildin T e 5 f G L_ .7 �I_I 1 s _ ' .Hai. erc�siarzciI_bn coZplet'' _ _ Number of Bedrooms + Has garbage grinder been installed? I certify that the system(s), as listed, serving the above premiF:i4 built plans (copies of which are attached), in accordance with ' plans and the standards, rules and regula s o the Putnoin Date: _ /C, 13 --'7 Fr- Certified by Address Any person occupying premises served by the above system(s) shall V as shown on the as- Permit and approved Y -7 - P.E. K R.A. //-) 6 Z'6) rz) *fly t&e' such action as may be necessary to secure the correction of any unsanitary conditions resulting from such usage. Approval of the separate sewage treatment system shall become null and void as soon as a public sanitary sewer becomes available and the approval of the private water supply shall become null and void when a public water supply becomes available. Such approvals are subject to modification or change when, in the judgment of the Public Health Director, such revoc tion, modificati n or change is necessary. r" By: Title: i`-' -'z Date: White copy - HD . ile; Ye ow copy - Building Inspector; Pink copy - wner; range copy - Design Professional Form CC -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES WELL COMPLETION REPORT Pv,,5-qj ♦. ', Lo1UoW&-tk YI ' K �df -Ad �/J.I. Mf.- •. C. W+ , �.... T�wir/'t�iliag�: '`L jr�'j L CJI �,►t e L v': _.• ..ffla.7 1 �e. Ma Block Lot( )V Well Owner: N Address: Use of Well: 1- primary 2- secondary x Residential Public Supply Air cond/heat pump Irrigation Business Farm Test/monitoring Other(specify) Industrial Institutional Standby Drilling Equipment Rotary Cable percussion Compressed air percussion Other (specify) , Well Type Screened Open end casing X Open hole in bedrock Other Casing Details Total length ft. Length below grade 9 Diameter > in. Weight per foot 4� lb /ft. Materials: Steel _Plastic _Other Joints: _ Welded Threaded _ Other Seal. Cement grout _ Bentonite Other Drive shoe: Yes _ No Liner:_ Yes �--ANo Screen Details Diameter (in) Slot Size Length(ft) Depth to Screen (ft) Developed? First Yes No Hours Second Well Yield Vest _ Bailed _ Pumped Compressed Air ours 74- Yield ;&rgpm Depth Data Measure from land surface -tic (specify ft) During yield test(ft) Depth of completed well in feet Well Log If more detailed information descriptions or sieve analyses are available, please attach. Depth From Surface Water Bearing Well Diameter(in) Formation Description ft. ft. Land Surface 2 a ;X 6 � If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information Pump Type Capacity Depth Model Voltage HP Tank Type Volume Date Well Completed 'td It 9� Putnam County Certification No. ? Date of Rep rt Well Driller (signature) NODE: Exact location of well with distances to at least :lnnanent/landmarfs to be provided on a separate sheet/plan. Well Driller's Name Address: S 52&- d-� Signature: Date: b,7/ White copy: HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 '. -.. 4 :. ... ..`e6, R YNL .�3 X*IO/WNTAL WORCEr2 YorktOawi 1�1es$!a #�1, lM.i. /{3396 (9141 243 -OW Albert H. PadoyaMi# Dipaactor ' tA8 . *i 3P . B08'782 m l *s 66Sd i6a[+! 9TAt pl= F 1 �NMMQfNN41/i1YiAMAM1�INr/r ..N MNYN YN Yw11lMAfNNM yMA1.IN.N..10.1MI.�pYq NYAIN.. ---- ----- --M.I- w/N./ SUNSET HILL PROP6ATIES 2ATiEMME TANENi 10/2.7/9®0 idOA Ise SVNSET HILL RID DATE/TIMR APC'Dt 10!$9/99 4 t80A. P►UTNAM YA=Y, NY ;Q157- OPWr DAM .11/04/gi ,l41QI�i t�t149- 3it6 -EQE� SAMPLING SITES 28 CH IM ROM AN1OOR NOfE8.,. a. WELL A.wr.I NrV M 1Mr.v w.INr i/ r 4>• I�Y M.IV'N p DATE FLAA PRO PuThAm Ck ?Y F Wil i�ra��9s ABSENT 1are-1me Um 10/27190 NY 101/09/98 NU 10/87/911 I m 10/27/98 MM 10/27/" Sa 10/27/98 pM 10/27/98 HN It3/a7/98 ALI 10/99/98 TUI �T9t SATISFACTORY SAN AND EPA FEn6RAL rRSTED, AT THE T Pb /" 4JAD i imi is for p EPA Mead 6 Copper than 10% of their than 15 ppb and a trt+stmvmt Must be potential. LANE, PUTNAM VALLEY W SAMPLE TYPE:..s PC MROEA'HAi3i�E13a TEMPFMATtM =.If=" MTHt NF �IA1rr NwlM.r �IMp...rN MI.. Ir.,p.IYw.I.INrAIAMN.IM�IYAINMy M4YArwNNN r AL - RAMBE COUPON Alw9kT /460 AL ABSENT t111 1.7 ' �G " =15 "p0b ' tTE NITROO 0." NOIL 0 0 10 TE - NITROO <-0-.01 f617L N/A i Fe) "40 & 360 M616 0 -0 6 S mp /l 103 NEW (MM) 0.01,6 AS& 4-0.3 tRs /1 11.56. N/A 7.9 LWTO b.5 -9.S 558. TOTAL Me NB& N/A rIN_ITY tAS 184 "RA. N/A DITY tTtJ� ti N d-g OrtTl! A O I; -T rr -' = .WATER- N 1 _ p� IRY 12�Lm 'ACCORDi . 'YORK STATE j WiNg WER WANDAMWi MA THE PARAMIERS OF G6 40TION. lic *chocks are set at 13 ppb. ule for Public Svst(1s Maui ®es that no more istrlbutlan points have a LEAH value of more OPM valuer of 1.9 me&,. *let water ndertaken to reduce tflel "aters corrosive Fol to If both iron ind pane" Set p+'e*#Atr thdir tetil value combined shalt not exceed 0.5 mg/L, No No l Wts for S6dWA are proscribed. SMI~ Quidelines state that far people +oA s sodium restricted d1* *%th* water should ,contain no mars th eo SO/L of Sodium. Far those on a modarately restric ad diat, a maxim 6f 2" ag1L of Sodium 19 suggssted. �.... a 3ROWNTAL NMICES I w [ V616betoWn gUt(ght%, t4aV. 105" 191-b) 243-2W* Albert H. Padovant v Director LAB Ot 32.809768 CL16MOo 6655 WN UAT PROC RRMT HILL PRwaRTIgs DATEMME r 10/97/" 07100A :lag SLWW WILL -RD gmys/yINK RECIal. lVVI" QN354 P VALLIEYO W x0m IMMT WEI WWI 99 SAWLINO SITts 99 CHERRV LAN@j,.PU?NAN VALLEY Vf VANFLE TYPE PUTA LE pmet"TIVES1 MR COL ID BY RMT 9MMINSIM TEMPMTUM NGTES.�.._. I WELL PVNI OW DATE FLAG PRMPME AEM&T W4 ER SCAL�f im VAS 644MFROM 1- 14. R-M nFuni-Ali-i AND ="-m;7-y Len Tes-rom im timR r-w-misTRY. PEP AS TME GM OF TM CALCIUM MA3NNITUM FTI-m-CIEW AND TREATM! F. TO WHICH THE WATIM MM BM w__UM;MC7=_-_ • '7Z. _ Q&A A id -i I 4 a "M 4 GUM41 TTEZ) BY s LFLOP4 I k________1.fUV W4 'VtJ k74;CZM1 I-MAIN LMINUJ�IM CIZONW EENG11 BERING .-PE K The Lindy Building, -Suite 200 2' CHN'. WALSH-: BOULEVARD. _JP9EKSKILL, NY 10566. (914) 736-3"4 FAX (914) 736-3693 Irlt-L TO podly" ASSistamt Public Health Engineer Putnam County Dept. of Health Dept of F-mvVvnmmtctt Services #4 Road remster, H.Y. U5(19 VE ARE SENMma YMJ Atu&ad I 1 .1,111 Z f-111i uld I w wJ11 1CwmS Gaye on SIUNSET HILL PROPERTIE-S. INC. LOT ,w 0 t CER11FICATE OF CONSTRUCTION COMPLIANCE PACKAGE CHERRY LANE L TOWN. OF PUTNAM VALLEY 1CwmS Gaye on 3 AS-BUILT SEPARATE SEWAGE DISPOSAL SYSTEM PLAN CERTIFICATE OF CONSTRUMON COMPLIANCE 3 GUARANTY OF SEPARATE SEWAGP* OISPOSAL SYS-"" Em 1 FOUNDATION LOCATION SURVEY MAP .1 WEL 'ON REPORT 1 1 5R ANALYSIS REPORT $200 CHECK FOR APPLICATION FEE ARE. T—VANSK" L WATER. 4AM4.V�I.S E% 07.- 07.--r » YML ENVIRONMENTAL SERVICES ` 321 Kear Street - -- -. n 105g8 - ^ ,.,����� -(914 2800~--`'~'='� Albert H. Padovani,Director , LAB W. 32.806590 CLIENT #: 6655 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ` SUNSET HILL PROPERTIES ' 158 SUNSET HILL RD PUTNAM VALLEY, NY 10579 ` NON STAT pROC PAGE 1 ~~~~~~~~~~~~~�~~~~~~~~~~~~~~~~~~~~~~~~~ DATE/TIME TAKEN:�07/28/98 07:00 DATE/TIME RECD: 07/29/98 09:22 REPORT DATE: ' 07/30/98 PHONE: (914)-526-2226 ` SAMPLING SITE: 28 CHERRY LANE, _PUTNAM VALLEY,'NY' SAMPLE TYPE..: POTABLE : OUTSIDE TAP . PRESERVATIVES: NONE COL'D,BY: BOB ANTOINETTE TEMPERATURE..: 4C NOTES. .�: � ' COLIFORM METH: MF `�~~~~~~~~~~~~~~~~~~~~~~�~~~~~~~~~~~~~~~ ~~~�~~~~~~~~~~~~~~~~~~~~~~~~�~~~~~~~~~~ ' DATE FLAG PROCEDURE RESULT . NORMAL ­RANGE METHOD 07/29/98 MF T. COLIFORM ABSENT /100 ML � ABSENT 1008 . COMMENTS: ` BACT THESE RESULTS INDICATE THAT THE A SATISFACTORY SANITARY QUALITY AC NEW YORK STATE . AND EPA FFDERALDRINKING WATER STANDARDS, FOR THE PARAMETERS TESTED, AT THE TIME OF COLLECTION. � -����.�-�`'�-���-������������������`�_-���` � V' ` ' ' SUBMITTED BY: ' Albert��. Padovani, M.T.(ASCP) Director ' ELAP# 10323 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES FINAL SITE INSPECTION Date: Sti eet'Locatrot` ;.rti ".. r "� _ Owner � f Town Permit # TM # Subdivision Lot # 1. Sewage System Area a. STS area located as per approved plans .................. b. Fill section - date of placement 3:1 barrier Lgth. ,' Width Avg.Dpth c. Natural soil not stripped .......... ............................... d. Stone, brush, etc., greater than 15' from STS area. e. 100' from water course / wetlands ............................ II. Sewage System a. Septic tank size - 1,000 ... ....1,250. ......other...... b. Septic tank installed leve ............................... c. 10' minimum from foundation ............................... d. Distri tuion Box 1. All outlets at same elevation -water tested....... 2. Protected below frost ........ ............................... 3. Minimum 2 ft.Original soil between box & trf Junction Box -pro erl set..... - �LengtFi required _ Length installed 2. Distance to watercourse measured Ft 3. Installed according to plan ............................... 4. Slope of trench acceptable 1/16 - 1/32" /foot... 5. 10 ft. from property line - 20 ft.- foundations 6. Depth of trench <30 inches from surface......... 7. Room allowed for expansion, 100 % ................ 8. Size of gravel 3/4 - 1 %" diameter clean .......... 9. Depth of gravel in trench 12" minimum.......... J9., „Pipe ends capped,...--. `rum or Dosed Systems Size of pump chain F r ...... ............................... 2. Overflow tank ................... ............................... 3. Alarm, visual / audio .......... ............................... 4. Pump easily accessible, manhole to grade...... 5. First box baffled ............... ............................... 6. Cycle witnessed by H.D.estimated flow /cycle III. HouseBuildin a. House located per approved plans ........................ b. Number of bedrooms ............. ............................... IV. Well a. Well located as per approved plans ...................... b. Distance from STS area measured Ulm ft . c. Casing 18” above grade ......... ............................... d. Surface drainage around well acceptable ............. V. Overall Workmanship a. Boxes properly grouted ......... ............................... b. All pipes partially backfilled . ............................... c. All pipes flush with inside of box ........................ d. Back fill material contains stones <4" diameter..., e. Curtain drain & standpipes installed according tc f. Curtain drain outfall protected & dir.to exist wat g. Footing drains discharge away from STS area..... h. Surface water protection adequate ....................... i. Erosion control provided ....... ............................... Rev. 1/97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES �GUA RAN. -TEE OF: SUBS [ 'AC =S: WA T1U� ME1i! 'N ..�%•1 a -M 1' �_ Sul- 4 -sc-r t 1 L(_ flka, E? t + ES Owner or Purchaser of Building SOn)SE T M L c_. t' to t"'�6Z-r) E-c' Building Constructed by c,! / Y W Location - 9treet 73 1 41.17- Tax Map Block Lot fv-rr4 a m VA z ,Lz Town/Village r RWSQMb1 1S10^j 4P for Z _Svr3SE7' HILL _ ROPE ?TfE.5 Irkc_ Wivision Name C MA +' +MCCO &46 � FAMI LV �k ~1' �D r1 GE 29 Building Type Satbdivision Lot # I represent that I am wholly and completely responsible for the location, workmanship, material, construction and drainage of the sewage treatment system serving the above - described property, and that is has been constructed as shown on the approved plan or approved amendment thereto, and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and hereby guarantee to the owner, his successors, heirs or assigm, to place in good operating condition any part of said system constructed by me which fails w operate for a period of two years immediately following the date of approval of the `=CertifrAde of Construction Compliance" for the sewage treatment system, or any repairs made by me to sash system, except where the failure to operate properly is caused by the willful or negligent act of the occupant of the. building utilizing the The undersigned further agrees to accept as conclusive the determination of the Public Health Director of the Putnam County Department of Health as to whether or not the failure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the system. Dated: Month I 0 Day 13 Year 9 8 Simpature: bA:LQaft�_ Title: &.r General On actor (Owner) - Signature SuWS'�__k " Otll e(20- of -f`TL 6 S NC .3 ^ _%E-r 41 L C. ,l Q'PER7IeS W C. Corporation Name (if corporation) Corporation Name (if corporation) Address: 1k6 mss¢ -7 Y14 1�u'l7u.4K t At, Address: )s$ , SOASCr AlIC.c rb- State L? Zip �C� �% % ,rate Pr i�M► LW r,. /. Zip o F7 Form GS -97 CRONIN ENGINEERING PE PC The Lindy Building, Suite 200 2 JOHN WALSH BOULEVARD PEEKSKILL, NY 10566 .. -d�;;.� . - •::;,:_�;�: =��.m did.... . - ._._....,., -�. -�_ -.. �..-;�:� �- (914) 736 -3664 FAX (914) 736 -3693 TOE Adam B. Stlebeling Assistant Public Health Engineer Putnam County Dept. of Health Dept, of Environmental Services #4 Geneva Road Brewster, N,Y, 10509 WE ARE SENDING YOU Attached IIMIDNIMI DATE jo B NO. NO. RE, SUNSET HILL PROPERTIES INC. LOT 2A CERTIFICATE OF CONSTRUCTION COMPLIANCE PACKAGE CHERRY LANE TOWN OF PUTNAM VALLEY COPIES DATE NO. DESCRIPTION 3 AS —BUILT SEPARATE SEWAGE DISPOSAL SYSTEM PLAN 3 CERTIFICATE OF CONSTRUCTION COMPLIANCE 3 GUARANTY OF SEPARATE SEWAGE DISPOSAL SYSTEM 1 FOUNDATION LOCATION SURVEY MAP 1 WELL COMPLETION REPORT 1 WATER ANALYSIS REPORT 1 $200 CHECK* FOR APPLICATION FEE THESE ARE TRANSMITTED For approvat REMARKS SIGNEDi JUN-25-1999 10:58 D J DONNELLY 914 962 2209 P.02 Area=, 7&:0,,YVz sq. 3. 810,6 Acres OI Z..'A.5-00. 1:16 :7. 9 5:7 Ce Ce 7 M :ma :cc d :om curb m-acadarri, gutter w. _, w_,. v...w CB pdvgTg fit n 2D b 17.5 1111 Y Cs curb C OP yRIGH r (g) 7-998 ooMALo J. DONNELLY, ALL RIGHTS RESERVED rnYArt+tti - otW* . li At =PA 77f)N op Anf)MON TO iS D J DONNELLY 914 962 2209 P.02 Area=, 7&:0,,YVz sq. 3. 810,6 Acres OI Z..'A.5-00. 1:16 :7. 9 5:7 Ce Ce 7 M :ma :cc d :om curb m-acadarri, gutter w. _, w_,. v...w CB pdvgTg fit n 2D b 17.5 1111 Y Cs curb C OP yRIGH r (g) 7-998 ooMALo J. DONNELLY, ALL RIGHTS RESERVED rnYArt+tti - otW* . li At =PA 77f)N op Anf)MON TO DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road, Brewster, New York 10509 (914) 278 -6130 'IJts_;;CONSTF,.�;C'f PCHD PERMIT WELL ; �`=:. v'. WELL LOCATION Street Address C ! lLV. Ci9 ^j� Jwn Village City Tax Grid Number RQ -T A QALLtZ 73- I- 4_1. I' SVc34 0_r 2Q ;WELL OWNER Name Mailing Address 1S"$ Su�s.ferr HALL 'fLb rivate uj st r !CC ItoIBCLTle -r iNC. 'PU �JA UA L(. /i. . I07 . O Public USE OF WELL 1 - primary 2- secondary 'RESIDENTIAL 0 BUSINESS 0 INDUSTRIAL O PUBLIC SUPPLY O AIR /COND /HEAT PUMP D ABANDONED O FARM O TEST /OBSERVATION O OTHER (specify, b INSTITUTIONAL O STAND -BY O AMOUNT OF USE YIELD SOUGHT gpm/ # PEOPLE SERVED /EST. OF DAILY USAGE S(3 0 gal 13 REPLACE EXISTING SUPPLY O TEST /OBSERVATION Llr ADDITIONAL SUPPLY NEW SUPPLY NEW DWELLING1 13 DEEPEN EXISTING WELL REASON FOR DRILLING .DETAILED REASON FOR DRILLING WATER Su ?P'.y Fo'iZ tJ60 'Rer .f IbE-M CC WELL TYPE DRILLED DRIVEN DDUG OGRAVEL 0 OTHER IS WELL SITE SUBJECT TO FLOODING? YES NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION:'F_E-Xujjb1 V 1� Ib J OF Co T- 2- Su.,ase-r H1tC 1 j1z,6 Lr7t- rie- -(" lOC: Lot No. 2M WATER WELL CONTRACTOR: Name , J iC6 �, T n)t?72MA/� {�NALS`lL•�c9n1 Address : �; � N� rh V AtLEV �.Y IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES o- NAME OF PUBLIC WATER SUPPLY: TOWN /VIL�e gBC NEW Y L. I?IST�9IIC T.Q, pR1-I?RTY. FRM. O NEAREST - WATER. MAIN,, HONi LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED `�ON SEPARATE SHEET" "' S - Zf Uj (date) (sign ) FE PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above is granted under the provisions of Subpart 5 -2 of Part 5 of the New York State Sanitary Code, and provided that within thirty (30) days of the completion of water well construction, the applicant shall: 1. Pump the well until the water is clear. 2. Disinfect the well in accordance with the requirements of the Putnam County Health Department attached to this permit. 3. Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant shall take appropriate action to assure that any and all water or waste products from such well drilling operations be contained on this property and in such a manner as not to degrade or otherwise minal-e-surface rface or groundwater. Date of Issue: 19 Date of Expiration 19 Z7 Permit Issuing Official Permit is Non - Transferrable White copy: HD File Pink copy: Owner 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller I •111''111'1.1 oil 111,1 hllhh,, l h hl I It11 "'q'1�'4 "�hlPltttllt'h�h'1. .1lljl'Ilt l'1111�'•h hjf'Ittlh't/ hh.. - IIIII�n1gt h�•�"{NN1144 til/ltihq�1 '•.,� •' .. S .--- .... -- Iu111u11uP,1, 11111 ' haht 1 r; • _ - - 1111 nl U,u 11111 Inl ! t 41t Itlllll+ 1 1 Ilftlrytl 11'tt h''4 /1�'t'tq.. '�' 1• n l lulu IIII111111111111 nit lllAlh 1111111 „ hl, "t"n.. • nnlllltl 111111 l 111t,t1111sllp'r t11p 11Nthltl n•,�. �l , , ,.,., 1 111111111111111 '•'.,R � I���hll � 11t1�, Iltll,,, �I,a.H IIIH 11111111111111 1t144�1�441 � 111h111 "'•PI~'"•bti� - i • 1 II.1 1 1111 Ihl/ 1111 ~1t1... 1 .11111 'L.� Ill 4ttlj 11111 �Ihh1111111 „1j. ; i �� � • � - - •.1 � - I /lllllllttlt'T Ilu• "1., ., •. • :. , 1 1 I I I • . .. 111411111111 tlphlto titN�'ul. J - 111 1711 1 1 1 _ d11oM 1146NNm, toll _ - 111. ,,,IIyY1 /1111U�r+� i111111111111111u11111111161 IMII - 1/ ditto X111 IIIINIIIIIHI /1IIHlltpll �� � 11 IItN Zl* Mllitilit - � ^' .Mt111NM/NM : � ' ilI i _ d111NfItItNMt ,4 11111 '1111 IIIH 11�� - �•'' IgIN111NIN1 � NIIINIItNltlI- - 1111 -N1/1 X11111111.11111. �� 1111 1'. :IIM HIw1A/N w �� �lilui ►i ��ii�i�i�i�i�i►i , I�I�I�I�lil�liiil �II�I�I►Illil�lllll Ill�l�l���lisi :.;w` 7V or. wmmnmmmmh RNA; u t, :SiN�! ?• w III a0' y 7. t if A � � 1: Y r • 1 IK�N�e• 1 y f FAMI�.Y RO0jW Klt' HEN/ 8KFST 4 X Is- O 201,, 78 X 13'— O' i A 1 27'8" 1 a LIVING ROOM 14'- 2" X 13'— O" 1 1 1 1 1/ 1 i; I DINING ROOM 1 Z'— 9' X W-08 Opti, r r c1� i a Y[ k 1 ;Y..,.O.RK HI.R ^40 H E S� idz: I 2T8 BEDR OOM I 10*-09X 13*- 0 BEDROOM 2 14' -40X 10' -8° N BEDROOM 4's, MINSIM�., "Ail open to be low 40 N -,-.,gt4ASTER BEDROOM :.Ivd'-3'* X IT-0• fii EO Putnam County Department —of Health Division of Environmental Sanitation -AFFIDAVIT - CORPORATE OWNER APPLICATION ,'`..� .v,,,,:e. .o: �'�e-- .-•.�. :-- x,.m.- -�.. ,;�:Qy; oo... :a>.'..�1� ..: 3.w ivy -. • .. �f�y •...- '.- ..�m -- .'7"c..i+y:¢Ik"+enm- .r••�'evL FOR PERMIT APPLICATION SUBMITTED . TO .• . PUTNAM.COUNTY HEALTH DEPARTMENT. TO: Commissioner of Health - In the matter of application for — — - = -- — ----------- repre sent that,h.am.an officer or .employee. of the corporation"and am :authorized to act for, S`.1n1 SE"r i LL (name 'of corporation) - having offices at LL_OA—_ _ — Pv_:�•tj 6,M "_�14 LLO/_ .!3_�%. .Whose .officers are Pre s a. den t " O_TC_1Z — j�,�s�—o- LN :c�"�'� 1. Su'L (Name and. Address) Vice- President --------------------- (Name and Address) Secretary — - - -- ------ - - - - -- (Name and Address)— .._ and that I am and will be individually responsible for any or all.acts of the corporation "with respect to the approval requested and all sub- sequent acts relating thereto. Sworn to before me this t( day Signed)( f 1917 Title — _pms0DCO__r____ Notary Public Notary PuM c, State of NI ew York - No. 4823313 Qualified in Westchester County Commission Expires March 14, 1996 Corporate Seal PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date \/')C 197:2. Re: Property of SQ^j ge-r 'F ROPER-Fled I/JQI Located at Cdc M( Z-1 c' 'To LJ,-j 01= 'Pu-i-rioinn (T)FQ7tjJ4N (Jjqte_E�Section Brock Lot Subdivision ofKe-xU0.bIUI4I'3A) OF 4OT- /A.) C Su.bdv. Lot .# Filed -Map �Date Gentlemen: This letter is to authorize e 20?Q I A.) -723r-- a duly licensed professional engineer o r.registere.d ,architect (Indicatej-- to apply for.a Construction Permit for a separate sewage system, to serve the above noted property in accordance with the standards, rules or regulations as.promulagated by the Commissioner of the Putnam County Department of Health, and to sign all necessary papers on my behalf-in .connection with this matter and to supervise the constructioni,of said sys'teffi-or' systeiiCg-"i�-n'"6*'o-n'to'rmity'-w"1.-th the provisions of Article 145 or 147, Education Law, the Public Health Law, and the Putnam County Sani- tary Code. C o uyA-e-q signed: . E . , # Address -ti/t-Zj,u_Dy \\� ? -3 Telephone N E X6 ITC 2 � 62980 Very truly yours, Signed Owner o furoperty Address /J2 lal? Town Telephone CRONIN ENGINEERING PE PC The Lindy Bullding, Suite 200 2 JOHN WALSH BOULEVARD PEEKSKILL, NY .10566 (914) 736 -3664 FAX (914) 736 -3693 T❑i Bill Hedges Assistant Public Health Engineer Putnam County. Dept. of Health Dept, of Environmental Services #4 Geneva Road Brewster, N.Y. 10509 VE ARE SENDING YOU Attached I.I: I i l:i'Z (1)I Ii'l � \ti�lil•I I �I. DATE.. e JOB NG. TE ATNTION . BILL HEDGES RE' SUNSET HILL PROPERTIES INC. LOT 28 SSDS CHERRY LANE TOWN OF PUTNAM VALLEY COPIES DATE NO, DESCRIPTION 3 PLOT PLAN & SEPARATE SEWAGE DISPOSAL SYSTEM 2 HOUSE PLAN 1 CONSTRUCTION PERMIT APPLICATION 1 APPLICATION FOR APPROVAL OF PLANS 1 LETTER OF AUTHORIZATION 1 V CORPORATE RESOLUTION 1 SOIL DATA SHEET OQ- C€RTFIED CHEC K.,_,F R -APPLE ATION .FEE i THESE ARE TRANSMITTED REMARKS WE-4-L' IPE21^I l T' 1 ?1' C) CA T 10 A J For approval APPENDIX 3 PUTNAM COUNTY DEPARTMENT OF HEALTH - DIVISION OF ENVIRONMENTAL HEALTH SERVICES INDIVIDUAL WATER SUPPLY dt SUBSURFACE SEWAGE.DISPDSAL S ]�F, MS.�rK -., ,,,.• w: :f. , ritiY' rc3i `CONSIR:fiZ3i1V'PERMIT.;s�.•J�. �,,✓��, STREET LOCATION /�� Avt"�� NAME OF OWNER!/Y� f /�11%' 0"- ' BY B. HEDGES R.MORRIS OTHER S ' a� DATE TAX MAP #_ -_1- -� ' la Z DOCUMENTS. PERMIT APPLICATION PC -1 WELL PERMIT= PWS LETTER AUTHORIZATION DESIGN DATA SHEET(DDS) CORPORATE RESOLUTION S THREE SETS HO E PLANS - TWO SETS PIT & D BOX SHOWN & DET r_u USE - NO.O WELLS & SSDS'S WAN 200 FT. OF PROPOSED SYSTEM OPERTY METES & BOUNDS HOUSE SETBACK NECESSARY (TIGHT LOT) . HOUSE SEWER - 1 /4 "/FT. 4 "0; TYPE PIPE NO BENDS; MAX. BENDS 45° W /CLEANOUT OLE)ALSI FILL SYSTEMS UB DIVISION CLAYB R BDIVISION � " 10 FT HORIZONTAL: SLO E 3:1 TO GRADE IVISION APP OVAL CHECKED FILL SPECS FILL NOTES RATE '�� FILL CERTIFICATION NOTE FILL REQUI i k- f nD H DEPTH GAUGES CURTAIN DRAI JiD STANDPIPES FILL PROFILE &DIMENSIONS GENERAL VOLUME EX- ROYAL SSDS ADJ. LOTS O `' ( FILL IN EXPANSION AREA ETLAND ( TOWN/DEC PERMIT REQ ?) TRENCH' %S ATA ON DDS PLANS &PERMIT SAME �I F RENCH PROVIDED 60 FT MAX - 1969 -NEIGHBOR NOTIFIFICATION ARALLEL TO CONTOURS ., _I=__ERFi/Z.LRA !'t/ - _ ci " /o`EXPAIe! ION?= ttrz��r�FT� 100 YR. FLOOD ELEVATION NO l e ud;L4:w&-- `j���'°` fb 6-5 +s txj.,_ PARATION DISTANCES SPECIFIED ON PLAN REQUIRED DETAILS ON PLANS FI LDS _, _ SEWAGE SYSTEM PLAN - (NORTH ARROW) 10.1 TO P.L. DRIVEWAY LARGE TREETOP OF FILL SSDS HYDRAULIC PROFILE GRAVITY FLOW 20' TO FOUNDA ALLS 15' WELL TO P.L CONSTRUCTION NOTES (GRINDER NOTE) —. 100 TO WELL, 200' IN D.L.O.D., 150' PITS DESIGN DATA: PERC AND DEEP RESULTS 100 TO STREAM WATERCOURSE LAKE (INC.EXPAN) TWO -FOOT CONTOURS EXISTING & PROPOSED 50' TO CATCH BASIN, 35' STORMDRAIN, PIPED WATER DRIVEWAY & SLOPES CUT ' TO WATER LINE (PITS 720') FOOTING /GUTTER/CURTAIN DRAINS V1, INTERMITTENT DRAINAGE COURSE EROSION CONTROL; HOUSE,WELL, SSDS ® 200 FT. RESERVOIR, ETCH 150 FT. GALLEY SYSTEMS EROSION CONTROL NOTE Kfl,45'M�N TO C.D. S= �5 %,20'- 4 %,25'- 3 %,30'- 2 %,35' -1 %,100' <1% PER & DEEP HOLES LOCATED tZI 20' IN TO C.D. DISHARGE /100' WITH 182 CONS DAY DIS. OF PRIMARY AND EXPANSION SEPTIf TANK LOCATION MAP ' 1 FROM FOUNDATION; 50' TO WELL COMMENTS: r \�rt PUMANK COMM DEPAR9MEM OF HEALTH \ Dmalau d wb�a.fal Bed& Sl rvlesa. Carmel. N.Y. 14512 to PWA& Paa.11t a. t70 N PRRMM FOR SEWAGE DISPOSAL SYSI'RM 141E s.. Z FiZ n S U all �-T H 1 L C- i�'tZ�i l�^j ?T ts_"'J' l N c• ---" -- qw.ar /AppRc..t ou CERINWATE O CB T I?U rtj&� UA Z c wra or VOW Tom... � -� .:. � :. ei�e""'4- -.1��, :r•�!u-+.1,.a.:�:;. � : _:r Renewd_ 0 - Rovkke 0 aLa T i� Date of Pmvbm Approval M•111111s M&M 1 S's SQ"Jxc -r HILL_ Town 'U r Jgr4t l}nce ey 2ap - 10 S' 7 9 nnto S::lhdiviczinn Annroved - Fee Enclosed Amn11Tt :K0Q� nwm,.. T, S iN cKE� Figrh rc y 'I�E Lot A.&_3 - Ii. i�c 'FEES Fm setna. vab.le pobee d Bedrooms ccr��Dedpt Flow G P D Goo PLED NotlRtutlon b Revulmd When FM le aagllated Sepeca/s Sewwalle Sydaus to oa.abt dJ�Galk. Sapdc Teak and +00 L F .©F 'Z'4"' CAAUC` OL T%ZE C N Te be oa.abuatad by CU—NI l''1 C.6A1 ?'R)i� r 1� 6' Adlbeaa 1C) UW STC _TL ILL 4RKE I'EE/tJICI t Z /J% Water Supply: PabOF Supply Feom Address are Pdwite Supply DdMW by/�ZM9A) A 192 C34 it . g-r AAA v/iCLE /�i, Olbar R.gadtema.a f't�� 1 errit LOP F It n1 8 Tc1 j U.^ E 1 represent that I am wholly and completely responsible for the design and location of the proposed above described will be constructed as shown on the approved amendment there to and in accordance County Department of MMRh, and that on completion thereof a "Certificate of Construction Co be submitted to ten Department, and a written guarantee will be furnished a owner, his suc place in good operating condition any put of said MWIl a disposal :Y d innth d ones of the appraral of the Certificate of Construction Compliant. the Iginr wul be locatedi s aheavo on the approved plan and that said well will b nstall w County Department of Health, D.t. - / —G 4,2V O 1 Jv ��ne. f /. Address APPROVED FOR CONSTRUCTION: This approval expires two years from the date issued unless 4 revocable for cause or may be amended or modified when considered necessary by the Commissions requires a new permit. Ap ed for disposal of domestic unitary sewage, a r' till Rev . ,c%Gz e- - - -67 10/88 cote satisfactory to M or aMURbStat the the or of Healtli will said builder will date of the ;Nlw described 860w I the Putnam R.A. i y Nn Undertaken and n is �yt�in� alteration of construction Title L �T L �Ur?sS GOEJI�?'iT?�A?��'�f%3tiT APPLICATION FOR APPROVAL OF PLANS FOR A WASTEWATER DISPOSAL SYSTEM. 1. Y Name and Address of Applicant: S_ Q^J S CT ii' I t L f '''I 66'09- 7'I c-S >l A;-9 Su�S' .T' ��ILL TZd✓�D 2. Name of Project: sSb S 3. Location 9V /C: Rjp -JqM JAtzt)y 4. Project Engineer: itmo i 2. 25. Is State Pollutant Discharge Elimination System (S ?DES) Permit required ?.. NO 26. Has S DES application een`" Sib 6rti`tie2P: "Io l"T E ' 0,ff 27. Is any portion.of this project located within a designated Town or State wetland ?.. A)O JAi Z3. Wetland ID Number .......................... ... 29 Is Wetland Permit required? ..... ..... .... ..... N d Has application been made to Town or Local DEC Office? N 30: Does project require a• DEC. Stream Disturbance Permit? 31. Is or was project site used for agricultural activity involving application of pesticides to orchards, or other crops, solid or hazardous waste disposal, landf- illing, sludge.application or industrial activity? ........ YES o.r NO ^3V 2. Is project•located within 1,000 feet of existence of abandoned landfill, hazardous waste site, salt stockpile, landfill, sludge disposal site or any other potential known source of contamination? ...Y -S or NO NO DESCRIBE: .3?. Is there 'a :local master plan or file with the Town or Village? 31. Are community water, sewer facilities planned to be developed within 15 years? iu0 35. Are any sewage disposal areas in excess of 15% slope? ........................ �_ _. - 3o ..Tax Map ID Number .......... ............. ........:::. ......- :.......: ^t i7. Approved Plans are to be returned to: ................ Applicant ek Engi.neer :f the application is signed by a person other than the applicant shown in Item 1, the .!pplication must be accompanied by a Letter o.f. Authorization. Failure to comply with this ')rovision maybe grounds for the rejection of any submiss' E W yo RIr I hereby` affirm, under Pena 1 t of; perjury, t a normati�Bt3y r ided on this form is true to the best o my k owledge a e a nts`made herein are punishable es Clas A His anon rs Se tin 210.45 of the Penal Law. ; ,' ;1G.NATUr; =S £. O=PIC;;' TIT! ES r�io r �l y c NuQo; 9119 . I.?U c E ��c7 Z 'SYU NnJ i J q L-CN Z� Ir.?LING ADDRESS- `PcElc- s�'ILL, �JEU kU2l� 10�'�-� ku PUTNAM COUNTY DEPARTMENT OF . DIVISION OF. ::ENVI1U4MENTAL HFALTH,SE1MCES DESIGN DATA SHEET- SUBSUFACE SEWAGE DISPOSAL SYSTEM FILE NO Owner-,, uo N 14LL N E�2 c r o . Aaaress Py ri,) A rh V A c cc V, n), y 1 o j 7 l Located at (Street)C E2d_)� 41-we Sec. 41,12 Block d Lot 41.12 (indicate nearest cross street) SvaCoT- Z Municipaiity i,3,J OF vTr�A>'� JA'LLCII Watershed �kbs �,1 SOIL PRKULATION TEST DATA RBQUIRED TO BE SUBMITTED WITH APPLICATIONS Date of Pre - Soaking 4- k`1 1- Date of Percolation Test 1.1so 7 HOLE NUMBER' CI= TIME PERCOLATION PERCOLATION Run Elapse Depth to Water From Water Level 'No. Time Ground Surface In Inches Soil Rate Start -Stop Min. Start Stop Drop In Min/In Drop Inches Inches Inches L1101, lo" 2 62 o 34- 17-, l.�,. 3 03S7 Oro �- 4 5 11.13 1134-. Z. `l- l lo" l O i 1 -7 Of 3 1 2 3 5• NOTES: 1. Tests to be.. repeated' at same depth until approximately equal soil rates Are obtained at each percolation test.hole. All data to'be submitted for review. 2. Depth measurements:.to be made fram top of hole. rev. 9/85 TEST PIT DATA • E0UI1M TO­BE STR-VJr 4!4� .li4Y. 4PPLIC4TIjjk7 DEPTH HOLE NO. D S� HOLE N0. `D Z b3 HOLE N0. 4- - - - T. . � - : �. ;'.aA:.w+ "..� _`•.t- ..,,."a. +:�' :.*,,.���r „' •�� ...`F- oi.. ��_ . o,._�: -;o..:e: . e :'”' 9.;"..., -::.` .,.:'- va::cr•:�.;- :,;.t.;s,�: G.L. FoP,S(31aL -7-© PSy %L 1"�SU iZm 1° SzD ^3by LOAM Loo/'"'1 SA'Jbx 2 � .. &Qo jb CIZAuc L. _ Sig b 6q1 P yg. C Si9,J-h 6i2a Ue C .31 41 C r tt I r 51 19 TE.IZ W11 TEX 71 NO WATER 13' 14' INDICA EE LEVEE AT WHICH G'ROUMI M-TER IS 1Nt`0, UNTMED - INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED DEEP HOLE OBSERVATIONS MADE BY: Tj r'hoTH DATE: 4 %30111 DESIGN Soil Rate Used Min /1" Drop: S.D. Usable Area Provided 7S 006 No. of Bedrooms ..4- Septic Tank Capacity Z j Q gals, Type ejA o/JE / Absorption Area Provided By 00 L.F. x 24" width trench - . d''"• J� w c w y 0 Other t�� r t? %1,ftc l'"•t . 2 ',a, F �S �q nl t.'C 1z r Nam -n MU?'HV L. C. R-0 /J 1 Mr- Signature s Address"HE CarJb)� 94-bG - Sy 1T-E 2-06 SEAL 629 `P E C_ Z¢ �'L) Y01 pROFESSO% THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: Soil Rate Approved sq.ft%gal., Checked by Date